Individual
MRS. SARA MALLAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
7305 NANTUCKET CT, 1A, INDIANAPOLIS, IN 46214-1294
(715) 853-5753
Mailing address
1436 S. LINCOLN ST., SHAWANO, WI 54166
(715) 526-6111
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
075376
IA
225X00000X
Occupational Therapist
31005738A
IN
225X00000X
Occupational Therapist
Primary
6234-26
WI
Other
Enumeration date
01/02/2015
Last updated
01/14/2019
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